List of Nursing Diagnosis

Nursing Diagnosis for Leukemia: Risk for infection related to the decline in the body's defense system, the secondary; white blood cell maturation disorders, increased number of immature lymphocytes, imonosupresi, bone marrow suppression.

Goal:
The patient is free from infection.

Expected outcomes:

• Normotermia.
• Culture results (-).
• Improved healing.

Nursing Intervention:

• Place in a special room, limit visitors.
• Wash hands for all personnel and visitors.
• Monitor temperature, consider the relationship between the increase in temperature with chemotherapy treatment.
• Prevent chills: increase fluid, give baths compress.
• Suggest to frequently change position, breath and cough.
• Auscultation of breath sounds, crackles, inspection secretion to change characteristics.
• Inspection skin to tender, erythematous.
• Inspection of oral mucous membranes.
• Improve the patient's perineal hygiene.
• Give uninterrupted rest period.
• Suggest to increase high in protein and fluid input.
• Avoid invasive procedures if possible.

Collaboration:

• Give medications as indicated.
• Avoid antipyretic containing aspirin.

Nursing Care Plan for Anemia

Nursing Diagnosis : Risk for Infection

Definition : Increased risk of entry of pathogenic organisms.

Risk factors :

• Invasive procedures.
• Insufficient awareness to avoid exposure to pathogens.
• Trauma.
• Tissue damage and increased environmental exposure.
• Rupture of amniotic membranes.
• Pharmaceutical agents (immunosuppressants).
• Malnutrition.
• Increased exposure to environmental pathogens.
• Imonusupresi.
• Imum ketidakadekuatan made.
• Inadequate secondary defenses (decreased hemoglobin , Leukopenia , suppression of inflammatory response).
• Inadequate primary defenses (broken skin, traumatized tissue, decrease in ciliary, static body fluids, secretions changes in pH, changes in peristalsis).
• Chronic disease.

Goal : increase the client 's immune status .

Outcomes :

• Free from signs and symptoms of infection.
• Demonstrated ability to prevent infection.
• The number of leukocytes within normal limits.
• Demonstrate healthy behavior.

NIC :

Infection Control

• Clean up the environment after use for other patients.
• Maintain isolation techniques.
• Limit visitors when necessary.
• Instruct visitors to wash their hands when leaving the visit and after visiting a patient.
• Use antimicrobial soap for hand washing.
• Wash hands before and after each nursing action.
• Use suit , gloves as protective gear.
• Maintain aseptic environment during the installation of equipment.
• Change the location of the peripheral IV and central line and dressing in accordance with the general instructions.
• Use intermittent catheters to decrease bladder infection.
• Increase the intake of nutrients.
• Provide antibiotic therapy if necessary.

Infection Protection

• Monitor signs and symptoms of systemic and local infections.
• Monitor granulocyte count, WBC.
• Monitor susceptibility to infection.
• Limit visitors.
• Filter visitors to infectious diseases.
• Partahankan aspesis technique in patients who are at risk.
• Maintain isolation techniques if necessary.
• Give the skin of the treatment area epidema.
• Inspection of skin and mucous membranes of the redness, heat, drainage.
• Inspection of the condition of the wound / incision surgery.
• Encourage enter adequate nutrition.
• Encourage fluid intake.
• Instruct the break.
• Instruct the patient to take antibiotics as prescribed.
• Teach the patient and family the signs and symptoms of infection.
• Teach how to avoid infection.
• Report suspicion of infection.
• Report positive cultures.

Nursing Diagnosis :  Risk for Infection

Ovarian cysts are small fluid-filled sacs that develop in a woman's ovaries.


Risk factors :

• Irregular menstrual cycles
• History of previous ovarian cysts
• Early menstruation (11 years or younger)
• Increased upper body fat distribution
• Infertility
• Hypothyroidism
• Infertility treatment with gonadotropin medications
• Tamoxifen (Soltamox) therapy for breast cancer
• Cigarette smoking also increases the risk of functional ovarian cysts.

Symptoms

• Lower abdominal or pelvic pain, which may start and stop and may be severe, sudden, and sharp.
• Feeling of lower abdominal or pelvic pressure or fullness.
• Irregular menstrual periods.
• Long-term pelvic pain during menstrual period that may also be felt in the lower back.
• Pain or pressure with urination or bowel movements.
• Pelvic pain after strenuous exercise.
• Nausea and vomiting.
• Infertility.

Nursing Diagnosis for Ovarian Cysts :

Risk for Infection related to a decrease in the primary defense


Goal (NOC)

expected infection control.

NOC :

• Immune Status.
• Knowledge : Infection control.
• Risk control.

Outcome :

• Free from signs and symptoms of infection.
• Describe the process of transmission of the disease, factors that influence the transmission and management.
• Demonstrated ability to prevent infection.
• The number of leukocytes within normal limits.
• Demonstrate healthy behavior.

Interventions (NIC)

Infection Control.

• Clean up the environment after use for other patients.
• Maintain isolation techniques.
• Limit visitors when necessary.
• Instruct visitors to wash their hands during a visit and after leaving the patient's visit.
• Use antimicrobial soap for hand washing.
• Wash hands before and after each nursing action.
• Use suit , gloves as protective gear.
• Maintain aseptic environment during the installation of equipment.
• Change the location of the peripheral IV and central line and dressing in accordance with the general instructions.
• Use intermittent catheters to decrease bladder infection.
• Tingktkan nutritional intake.
• Provide antibiotic therapy if necessary.

Infection Protection (protection against infection)

• Monitor signs and symptoms of systemic and local infections.
• Monitor granulocyte count, WBC.
• Monitor susceptibility to infection.
• Limit visitors.
• Filter visitors to infectious diseases.
• Keep aspesis technique in patients who are at risk.
• Maintain isolation techniques if necessary.
• Give skin care on epiderma area.
• Inspection of skin and mucous membranes of the redness, heat, drainage.
• Ispeksi condition of the wound / incision surgery.
• Push enter adequate nutrition.
• Encourage fluid intake.
• Suggest to break.
• Instructed to take antibiotics as prescribed.
• Teach the patient and family the signs and symptoms of infection.
• Teach how to avoid infection.
• Report suspicion of infection.
• Report positive cultures.

Nursing Diagnosis: Risk for Infection NIC NOC

NOC and indicators

NOC: infection control and risk control, after nursing interventions, there is no secondary infection, with:

Indicator:

1. Free of any signs of infection.
2. Normal leukocyte numbers.
3. Patients say knew about the signs of infection.

NIC and activities

NIC:  Wound Care
Activity:

1. Observe signs of wound infection.
2. Perform breast care with aseptic technique and use sterile gauze to treat and cover wounds.
3. Instruct the patient to report and recognize the signs of infection.
4. Manage your therapy according to the program.

Rational

1. Marker of the infection process.
2. Avoid infection.
3. Preventing infection.
4. Accelerate healing.

NIC: Control of infection
Activity:

1. Limit visitors.
2. Wash hands before and after treating patients.
3. Increase nutrient inputs sufficient.
4. Encourage adequate rest.
5. Ensure aseptic handling area IV.
6. Provide health education about risk for infection.

Rational :

1. Prevent secondary infection.
2. Prevent nosocomial infection.
3. Increase endurance.
4. Helps relaxation and helps protect the infection.
5. Prevent infection.
6. Increasing patient knowledge.